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Journal of Nursing Theory and Practice

JUNE 30, 2016

[Associated factors of independency in older adults with cognitive impairment living in a long term care institute]

KOVÁCS Éva, JÓNÁSNÉ SZTRUHÁR Izabella, KARÓCZI Csilla Kata, VASS Zsolt, FARKAS Lilla

[Aim of the research: Functional independence determines the elderly’s health and quality of life. In them cross-sectional study the authors analysed the associations between functional abilities (balance, gait, functional mobility, cognitive abilities), age, BMI and comorbidities and independency in older adults with cognitive impairment. Research and sampling methods: 110 elderly people were measured. Self-sufficiency was measured by the Katz-index, balance, and gait by the Tinetti Test and functional mobility by the Timed Up and Go Test. Correlations between variables were analysed with the Spearman’s rank-order correlation. Results: There was strong association between balance (r=0,557), gait (r=0,515), functional mobility (r=-0,647), and independency. It means the better the balance, gait, and functional mobility is, the higher the independency is. There was weak association between age, BMI, cognitive abilities, comorbidities and independency. Conclusion: Results show that preserving of the functional independence in older adults with cognitive impairment is a multidisciplinary task: physiotherapists and nurses should work together to complete doctors’ curative work of chronic diseases.]

Clinical Neuroscience

SEPTEMBER 30, 2016

[Dissections of the supraaortic arteries]

CSEH Tamás, SZUKITS Sándor, SZAPÁRY László

[Dissection of the cervical and intracranial vasculature is a rare but important cause of ischaemic stroke especially in young adults. In the majority of cases it affects the extracranial vessels, mostly the internal carotid artery. It might be categorized as spontaneous or traumatic, causing diverse clinical symptoms. Dissection might lead to ipsilateral stroke mainly by artery-to-artery embolisation. Due to its relative rarity compared to the classic ischaemic stroke of the elderly, there are much less clinically relevant information for the clinician to rely on. Several large, randomised, multicentered, prospective studies and some smaller, retrospective analyses have been published recently concerning the genetic background, epidemiology, acute care and secondary prevention of supraaortic arterial dissection which helps the neurologist to provide evidence-based care for his patient. Our aim is to give a short, up-to-date overview of arterial dissections with two case reports.]

Lege Artis Medicinae

NOVEMBER 03, 2015

[Current questions on Pneumococcus infections: cardiovascular complications, cardiotoxicity and new opportunities for prevention among elderly people]

LUDWIG Endre

[The respiratory tract infections, first of all severe pneumonia are associated with severe cardiovascular adverse events the significance of which that had not been recognised so far. Among the adverse events, the development of acute coronaria syndromes, heart failure, arrhythimias are the most important ones leading to significatly higher mortality even after several years. In the development of acute coronaria syndrome , the proinflammatory activites play the cenral role leading to the instability of coronaria plaques and plaque rupture associated with formation of platelet thrombi. The constriction of coronariae, peripherial vasodilatation and hypoxia also contribute to the deleterius complications. The role of pneumococci in this process seems to be especially significant since this pathogen exhibit a unique direct cardiotoxic effect, namely directly invades the myocardium and produce cardiotoxic substances. As a consequence, impairement of cardiomyocite function and contractility and formation of microscopic lesions in which later collagen deposition and long-term cardiac scarring can be detected. These pathological processes are developed despite of antibiotic treatment, consequently, vaccination against pneumococcal infection seems to be the only method for efficacious prevention of the myocardium damage and cardiovascular adverse events. According to the results of the CAPITA study, the conjugate polisaccharide vaccine decrease the number of pneumococcal pneumonia and invasive pneumococcal infections by 45 and 75% resp. in the elderly population. The recognition of the direct and indirect role of pneumococci in the development of early and late cardiovascluar adverse events gives a new aspect of the beneficial effect of efficacious vaccination.]

Journal of Nursing Theory and Practice

FEBRUARY 28, 2015

[Knowledge on elderly home care residents’ rights among caregivers and nurses körében]

MÉSZÁROS Lászlóné

[Aim of the study: To survey the awareness of carers and nurses regarding to patients’ rights as outlined in Act III of 1993 and Act CLIV of 1997, regulating welfare management, welfare services and health care. Sample and methods: The survey was conducted with the means of data collection with questionnaires, analysis of documents and statistical methods. The Survey was conducted in December 2013 and January 2014. The sample of respondents consisted of the carers and nurses of the Gödöllő unit of the Budapest Metropolitan Home for the Elderly. The analysis of the document aimed to introduce the of the house rules of the Home. The author used SPSS 22 statistical software to analyse the data collected with questionnaires. A chi squared test was employed to investigate the relations between the descriptive statistical methods and variables. Results: The knowledge of carers and nurses have deficiencies in the area of patients’ rights. They are more familiar with the rights provided for by the welfare act, as the majority of the workers have worked in the welfare area for a long time, and, in the course of their work have become aware of the rights described by the act in question. Conclusions: as the workers had no possibility to familiarise themselves with the patients’ rights during their education, the Home is to provide the workers with adequate training to make up for the above mentioned lack of knowledge. ]

Hypertension and nephrology

JUNE 25, 2015

[Management of patients with chronic renal disease]

KULCSÁR Imre, SZEGEDI János, KISS István

[The number of patients with chronic renal disease is increasing in our country and they are about one million people nowadays. The main causes of this phenomenon are increased number of diabetic, hypertonic, overweight and elderly people, as well as the presenting of calculated GFR results. The care of patients with renal diseases is an interdisciplinary work. Most of them are under care of general practitioners, but those, who are belonging to the high-risk groups, are treated by nephrological outpatients clinics. The capacity of Hungarian nephrological outpatients departments is insufficient, and the dispersion of them is uneven. For better nephrological care, the capacity of these outpatients clinics - including the human resources - must be increased.]

Lege Artis Medicinae

JUNE 01, 2015

[Analysis of long term care of elderly people in residential social institutions ]

HORVÁTH Zoltán, ENDREI Dóra, MOLICS Bálint, ÁGOSTON István, BONCZ Imre

[OBJECTIVES - The aim of our study is to analyse the institutional long term social care of elderly in Hungary. DATA AND METHODS - Data were derived from the following sources: Social Sector Information System, Regional Development and Planning Information System, and the Hungarian Central Statistical Office. The analysis covered the period 2001-2012. We analysed the number of operating beds in residential social institutions (pieces) and number of residents (clients) in residential social institutions. RESULTS - Between 2001-2012 the number of available operating beds in residential social institutions increased by 28.56%, from 42658 to 54840. The number of residents (clients) in residential social institutions increased between 2001-2005 by 3% annually, while since 2007 the rate of growth decreased due to the capacity regulation. The bed occupancy rate was 97.51% in 2001, and then between 2002 and 2007 it stabilized between 96.26%-96.87%. In 2008 it decreased to 93.44%, then after a continuous increase it exceeded the 95%. CONCLUSIONS - During the survey period, the bed capacities and the number of clients in residential social institutions showed an increasing tendency under high occupancy rate.]

Clinical Neuroscience

MAY 30, 2015

[Zonisamide: one of the first-line antiepileptic drugs in focal epilepsy ]

JANSZKY József, HORVÁTH Réka, KOMOLY Sámuel

[Chronic administration of antiepileptic drugs without history of unprovoked epileptic seizures are not recommended for epilepsy prophylaxis. Conversely, if the patient suffered the first unprovoked seizure, then the presence of epileptiform discharges on the EEG, focal neurological signs, and the presence of epileptogenic lesion on the MRI are risk factors for a second seizure (such as for the development of epilepsy). Without these risk factors, the chance of a second seizure is about 25-30%, while the presence of these risk factors (for example signs of previous stroke, neurotrauma, or encephalitis on the MRI) can predict >70% seizure recurrence. Thus the International League Against Epilepsy (ILAE) re-defined the term ’epilepsy’ which can be diagnosed even after the first seizure, if the risk of seizure recurrence is high. According to this definition, we can start antiepileptic drug therapy after a single unprovoked seizure. There are four antiepileptic drugs which has the highest evidence (level „A”) as first-line initial monotherapy for treating newly diagnosed epilepsy. These are: carbamazepine, phenytoin, levetiracetam, and zonisamide (ZNS). The present review focuses on the ZNS. Beacuse ZNS can be administrated once a day, it is an optimal drug for maintaining patient’s compliance and for those patients who have a high risk for developing a non-compliance (for example teenagers and young adults). Due to the low interaction potential, ZNS treatment is safe and effective in treating epilepsy of elderly people. ZNS is an ideal drug in epilepsy accompanied by obesity, because ZNS has a weight loss effect, especially in obese patients.]

Hypertension and nephrology

DECEMBER 20, 2014

[Epidemiology of hypertension in Hungary]

SZEGEDI János, KÉKES Ede, SONKODI Sándor, KISS István

[The most important aspects of Hungarian hypertension epidemiology are demonstrated. The prevalence of hypertension is continuously increasing and in 2011 from the nearly 10 million population exceeded 3 million. Its occurrence rises in parallel with the increase in of systolic blood pressure and the progression of age, and exceeds 60% in those aged over 65 years. The average blood pressure is increasing in children and adolescents, and isolated systolic hypertension is often observed in those over 65-70 years. The situation is closely related to overweight in the young, while in elderly the atherosclerotic process results in low diastolic blood pressure. The prevalence is significantly different in some regions with the highest incidence in South-Transdanubia and North- Hungary. Overall, there is a higher incidence in women. Among known hypertensive patients, the ratio of men is greater till 40-45 years; thereafter, there will be an equilibration and in elderly women the incidence will be higher. It is interesting, that the morbidity and mortality have significantly increased in hypertension and diabetes since 2004, while the incidence of myocardial infarction and stroke has significantly decreased. As concerns organ damage, an increase in occurrence of left ventricular hypertrophy and microalbuminuria has been observed. Metabolic syndrome, diabetes mellitus and ischemic heart disease were the most frequent comorbidities.]

Lege Artis Medicinae

JULY 20, 2014

[News in the therapy of age-related macular degeneration]

RÉCSÁN Zsuzsa

[Age-related macular degeneration is the leading cause of serious visual deterioration in elderly people. The progressive, degenerative maculopathy involves both eyes. The serious visual impairment is caused by geographic atrophy and subretinal neovascularization. Interaction between environmental and genetic factors is fundamental in the development of this multifactorial disease. Significant risk factors are the age, positive familiy history and smoking. In early stages, prevention and vitamin supplementation play important role. Modern therapy of subretinal neovascularization is the inhibition of VEGF. No known treatment has been yet available for geographic atrophy.]